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When treating breast cancer with a mastectomy, the nipple is typically removed along with the rest of the breast. (Some women might be able to have a nipple-sparing mastectomy, where the nipple is left in place. This is discussed in more detail on our page about mastectomy.)
If you’re having breast reconstruction after your mastectomy, you can decide if you want to have the nipple and the dark area around the nipple (areola) reconstructed through surgery or tattooing, or both.
The nipple and areola are usually the final phase of breast reconstruction. This is a separate surgery done to make the reconstructed breast look more like the original breast. It can be done as an outpatient surgery or sometimes as an office procedure. It’s usually done about 3 to 4 months after surgery after the new breast has had time to heal.
Ideally, nipple and areola reconstruction tries to match the position, size, shape, texture, color, and projection of the new nipple to the natural one (or to each other, if both nipples are being reconstructed). Tissue used to rebuild the nipple and areola comes from the newly created breast or, less often, from skin from another part of your body (such as the inner thigh). If a woman wants to match the color of the nipple and areola of the other breast, tattooing may be done a few months after the surgery.
Some women opt to have just the tattoo, without nipple and areola tissue reconstruction. A skilled plastic surgeon or other professional may be able to use pigment in shades that make the flat tattoo look 3-dimensional.
Another option for women who might not want further surgery or tattooing are nipple prosthetics, which are made of silicone or other materials and look and feel like real nipples. They can be attached to the chest and then taken off when you choose.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
American Society of Plastic Surgeons. Breast Reconstruction. Accessed at https://www.plasticsurgery.org/reconstructive-procedures/breast-reconstruction on August 6, 2021.
Jagsi R, King TA, Lehman C, Morrow M, Harris JR, Burstein HJ. Chapter 79: Malignant Tumors of the Breast. In: DeVita VT, Lawrence TS, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.
Mehrara BJ, Ho AY. Breast Reconstruction. In: Harris JR, Lippman ME, Morrow M, Osborne CK, eds. Diseases of the Breast. 5th ed. Philadelphia: Wolters Kluwer Health; 2014.
Momeni A, Ghaly M, Gupta D, et al. Nipple Reconstruction: Risk Factors and Complications after 189 Procedures. Eur J Plast Surg. 2013;36(10):633–638.
Nahabedian MY. Factors to consider in breast reconstruction. Womens Health (2015) 11(3), 325–342.
Nahabedian M. Overview of breast reconstruction. In Collins KA, ed. UpToDate. Waltham, Mass.: UpToDate, 2021. https://www.uptodate.com. Accessed August 6, 2021.
National Cancer Institute. Breast Reconstruction After Mastectomy. 2017. Accessed at https://www.cancer.gov/types/breast/reconstruction-fact-sheet on August 6, 2021.
National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Breast Cancer. Version 5.2021. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf on August 6, 2021.
Last Revised: October 20, 2021